Description

Who we are: 

Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most – patient care. Rooted in the 100-plus-year legacy of its founding partners, the network spans the Northeast with 128 physicians, over 1100 employees, and 28 locations from Connecticut, New York, and Massachusetts.

At Orthopedic Associates of Dutchess County, we believe our employees are our greatest asset. We believe in hiring the best people and cultivating a winning team. Investing in our employees’ future success is investing in our future success. We hire both experienced medical staff as well as those just starting out in the field looking for an opportunity to learn a profession. We promote from within whenever possible because we know our staff are highly trained and guided towards success!

What you’ll do: 

The Certified Professional Coder will receive, review, and enter all charge documents, including office and hospital-based services. The Certified Professional Coder is responsible for the input of all charges related to the assigned physician or professional service, into the practice management system and is responsible for reviewing billing and procedure codes to ensure all billing guidelines are followed correctly. The Certified Professional Coder is classified as a nonexempt employee and is eligible to overtime pay with prior approval and in accordance with the practice’s personnel policies.

Responsibilities/Duties:

• Bill and enter charges in a timely manner in a high-volume setting.
• Ensure charge information provided is correct and accurate,
• Review the coding at charge entry to ensure compliance with insurance guidelines, and accurate and timely reimbursement,
• Append modifiers based on payer specifics, insurance and authorization requirements and referring physicians’ unique attributes and add specific data such as, CPT and ICD-10 codes and date of injury (DOI) when needed.
• Verify all demographic and insurance information in patient registration to ensure accuracy for claim processing.
• Accurately examine charges for completeness.
• Correct claims as needed when denied by insurance carriers.
• Enter surgical claims based on operative reports and physician recommendations to achieve optimal reimbursement.
• Monitor communication systems to obtain charge information for hospital services, including all in-hospital stays, out-patient, emergency room and consult services.
• Attend Orthopedic coding seminars to stay current with changes,
• Provide information pertaining to billing, coding, managed care networks, insurance carriers and reimbursement to physicians, managers and other staff.
• Review coding newsletters for changes or guidance with proper coding
• Successfully complete other duties as assigned including but not limited to, missing encounter reports and missing DME/VISCO charge reports.
• Cross train and provide backup coverage as needed.
• Maintains a professional work demeanor when interacting with co-workers or communicating with patients, physicians, and administration,
• Complete other duties as assigned by the Revenue Cycle Leadership

Qualifications

Who you are:  

Qualifications:

• Certified Medical coding Certificate
• Minimum of 2 years previous Orthopedic Coding, charge entry
• Knowledge of HCPC’s, ICD-10 and CPT medical coding
•  Knowledge of Global billing regulations
•  Knowledge of CCI edit rules as well as bundling and unbundling code requirements,
•  Ability to code claims from office notes.
•  Knowledge of Insurance reimbursement guidelines
•  Polite telephone etiquette and good communication skills (written and oral)
•  Computer literacy skills, including practice management software, EMR, Microsoft Office
•  Detail oriented and strong organizational skills
• Self- starter, team player, analytic & problem-solving ability

What we offer: 

• Excellent growth and advancement opportunities 
• Dynamic environment 
• Access to a diverse network of practitioners 
• Broad infrastructure of tools and programs to enhance the employee experience,  
• Competitive Compensation 
• Generous PTO  
• Benefits package: health, dental, vision, 401(k), etc. 

We are an equal-opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex, or gender (including pregnancy, childbirth, and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as “protected characteristics”).